Knowledge Objective 2. Acute abdomen is a medical term referring to the sudden onset of abdominal pain, often associated with severe, progressive problems that require medical attention. Peritonitis will usually develop if the acute abdomen is not treated can be fatal.

Knowledge Objective 4. Because the nerves that monitor the visceral peritoneum are not as precise as the ones that monitor the parietal peritoneum, a patientwill not be able to localize and describe exactly where the pain is. Some painful sensations that occur because of an irritated viceral peritoneum may be perceived at a distant point on the surface of the body, such as the back or shoulder. This is referred to as referred pain.

Knowledge Objective 7. Causes of Acute abdomen 1.Ulcers: Protective layers of mucus that line the inside of the stomach and the duodenum are erroded, allowing acid to eat into the organ over a course of weeks, months and even years. Can caused by Helicobacter pylor and excessive use of nonsteriodal anti-inflammatory drugs. Alcohol and smoking can worsen the severity of PUD by increasing gastric acidity.

Signs and symptomsBurning/gnawing stomach pain that subsides or diminishes immediantly after eating and the reemerges 2 to 3 hours later. The pain usually presents in the upper abdomen, bu sometimes below the sternum. Nausea, vomiting, belching and heart burn are common symptoms. If the erosion is servere, hematemesis and melena can occur.

2.Gallstone: Gallstones can form in the gallbladder, blocking the outlet from the gallbladder, causing pain. Sometimes the blockage will pass, but if not, it can lead to severe inflammation of the gallbladder, called cholecystitis. In severe cases, the gallbladder may rupture, causing inflammation to spread and irritate surrounding structures such as the diaphragm and bowel.

Signs and symptomsConstant, severe pain in the right upper or midabdoinal region and may refer to the right upper or midabdominal region and may refer to the right upper back, shoulder area, or flank. The pain may steadily increase for hours or come and go. Cholecysitis commonly produces symptoms about 30 minutes after a particularly fatty meal and usually at night. General gastrointestinal distress such as nausea and vomiting, indigestion, bloating, gas and belching.

3.Pancreatitis:inflammation of the pancreas that can be caused by an obstructing gallstone, alcohol abuse, and other diseases.

Signs and symptomsSevere pain may present in the upper left and right quadrants and may often radiate to the back. Nausea and vomiting, abdominal distention and tenderness. Complications like sepsis or hemorrhage can occur, in which case, an assessment may reveal fever or tachycardia.

4.Appendicitis: inflammation of the appendix and a frequent cause of acute abdomen. This inflammation can eventually cause the tissue to die and/or rupture causing an abcess, peritonitis or shock.

Signs and symptoms: Pain caused by appendicitis is more generalized, dull and diffuse and may center in the umbilical area. The pain later localizes to the right lower quadrant of the abdomen. Can cause referred pain, nausea and vomiting, anorexia, fever, and chills, rebound tenderness.

5.Gastrointestinal Hemorrhage: Bleeding within the gastrointestinal tract which a symptom of another disease, not a disease itself. Can occur in the upper or lower gastrointestinal tract. Bleeding in the upper gastrointestinal tract occurs from the esophagus to the upper small intestine. Bowel inflammation, diverticulitis, and hemorrhoids are common causes of bleeding in the lower gastrointestinal tract.

6.Esophagitis: occurs when the lining of the esophagus becomes inflamed by infection or from the acids in the stomach.

Signs and symptomspatient may report pain with swallowing and complain of feeling like an object is stuck in his or her throat. Additional symptoms include heartburn, nausea, vomiting, and sores in the mouth. In the worst cases, bleeding can occur from the small capillary vessels within the esophageal lining or the main blood vessels.

7.Esophageal Varices: occurs when the amount of pressure within the blood vessels surrounding the esophagus increases. The esophageal blood vessels eventually deposit their blood into the portal system. If the liver becomes damaged and blood cannot flow through it easily, blood begins to back up into portal vessels, dialating the vessels and causing the capillary network of the esophagus to begin leaking. If the pressure begins to build, the vessel walls may fail, causing bleeding.

Signs and symptoms: Presentation of the esophageal varices take on two forms: Initially, the patient shows signs of liver disease – fatigue, weight loss, jaundice, anorexia, edema in the abdomen, abdominal pain, nausea, and vomiting. This very gradual process takes months to years before the patient reaches a state of extreme discomfort. Rupture of the varices is far more sudden. The patient will complain of sudden-onset discomfort in the throat. He/she may have severe difficulty swallowing, vomiting of bright red blood, hypotension, and signs of shock. If the bleeding is less dramatic, hematemisis and melena are likely.

8.Gastroenteritis: A family of conditions revolving around a central theme of infection combined with diarrhea, nausea and vomiting. Bacterial and viral organisms can cause this condition. These organisms typically enter the body through contaminated food or water.

Signs and symptomsUpset stomach, diarrhea, vomiting, nausea, large dumping-type diarrhea or frequent small liquid stools. The diarrhea may ontain blood and/orpus and it may have a foul odor or be odorless. Abdominal cramping is frequently reported. Fever and anorexia are also present. If the diarrhea continues, dehydration can occur, possibly causing shock.

9.Diverticulitis: Bacteria causing inflammation in the diverticula caused by a fiber deficiency. , caused by feces that become trapped there.

Signs and symptoms Abdominal pain typically localized to the left side of the lower abdomen. Classic signs of infection include fever, malaise, body aches, chills, nausea, and vomiting. Constipation and bowel obstruction can occur.

10.Hemorrhoids: created by swelling and inflammation of the blood vessels surrounding the rectum.

Signs and symptomsbright red blood during defecation though the bleeding tends to be minimal. Patients may experience itching and a small mass on the rectum.